Hospital lobbyist, Capitol Hill aide, healthcare consultant and now HCFA honcho, Michael Hash claims he's too boring to write about.
But the deputy HCFA administrator's own modest assessment conflicts with the rave reviews he gets from his former colleagues in Washington's healthcare lobbying and policy community.
They characterize him as what seems like an oddity in Washington: a straight shooter with integrity and a voluminous knowledge of how hospitals and providers function in the real world.
While his career has taken him in and out of the Washington power game, the seven years he worked for the American Hospital Association and the 13 years he spent at Health Policy Alternatives-a Washington-based healthcare consulting firm-exposed him to the pressures providers face.
Such experience was what HCFA Administrator Nancy-Ann Min DeParle was looking for in a deputy when she hired Hash in April 1998. DeParle has administered big government healthcare programs during much of her career.
"She wanted someone who could function as a partner with her," Hash said of DeParle in a recent interview at his office. "She's very comfortable with a strong leadership team. She expects the deputy to have a broad portfolio."
For hospitals, Hash's arrival puts somebody familiar with their operations back in a key position at HCFA. DeParle's predecessor, Bruce Vladeck, came from the United Hospital Fund of New York and now teaches healthcare policy at the Mount Sinai School of Medicine in New York.
Healthcare lobbyists said they were happy to see somebody with Hash's experience in a top HCFA post.
"To the degree that he has a knowledge of the hospital world . . . it puts somebody in a key position who understands our issues intimately," said Richard Pollack, AHA's executive vice president for federal relations.
"Mike brings a keen intellect and a background of understanding (hospital) issues to the table," added healthcare lobbyist Robert Betz, who was hired by Hash to work at the AHA.
Lobbyists also praised him for being open to their arguments, even in cases in which he ultimately rules against them.
"You can disagree with him on policy grounds, but you have to respect the intellectual process he's gone through to get there," said James Scott, president of the Premier Institute in Washington.
Part of Hash's broad portfolio has included taking HCFA's message to Capitol Hill, where the agency of Democratic appointees inevitably and visibly clashes with a Republican congressional majority that has oversight authority. Last year, Hash, a former House Energy and Commerce Committee aide, was HCFA's spokesman at several tense congressional hearings in which the GOP tried to put the agency on the defensive.
Although Hash said it was an "accident of scheduling" that he, not DeParle, has been HCFA's principal defender in Congress, lobbyists said he now has developed a reputation as the agency's designated punching bag.
One such hearing was last September, as Congress was drafting and passing legislation to revise the home health interim payment system enacted in 1997.
Hash and Tom Hoyer, director of HCFA's chronic-care purchasing policy group, were called before the House Ways and Means Committee to explain the administration's position on revising the IPS, which has been blamed for putting hundreds of home health agencies out of business.
Committee Chairman Bill Archer (R-Texas) asked Hash a series of terse yes-or-no questions about the Clinton administration's use of budget surplus money to solve the year-2000 computer emergency in federal agencies, including HCFA, and why the administration didn't consider the IPS enough of an emergency to also spend surplus money to increase home health payment rates.
That was relevant because fixing the year-2000 problem will delay HCFA's replacement of the interim payment system with a prospective payment system for home health agencies until 2000, a year late.
Hash parried those questions, expressed a willingness to work with Congress to revise the payment system and subtly criticized a GOP proposal for increasing home health payments by $1.4 billion without proposing spending cuts to offset that increase.
"The Republicans would have loved to have somebody from the administration say IPS was an emergency," said Randy Fenninger, a lobbyist who worked for home health groups in the last term of Congress. "Somebody might have said it, but it wasn't going to be Mike Hash."
As a former Capitol Hill staffer, Hash also understands what members of Congress are trying to do when they put an administration official on the spot, Fenninger said. "He's one of the only people in a senior HCFA position who's been on that end of things," he said.
Hash tries to take it in stride.
"I try to recognize that folks are trying to do their jobs," Hash said. "Sometimes the questions are pointed and the environment is kind of a fishbowl because there are a lot of people around, and that heightens the tension."
Demonstrating how hard it is to find anybody who will say anything bad about Hash, a GOP congressional aide criticized HCFA management but praised Hash.
"He's got great (Capitol) Hill experience, and we personally have had good relations with him," the aide said.